AHA and AMA filed lawsuits on accidental billing arbitration proceedings


The American Hospital Association and the American Medical Association sued the federal government for plans on Thursday Accidental Billing Arbitration ProcessThese groups claim that this unfairly benefits insurance companies and violates Congress’s intentions.

These organizations require the U.S. District Court for the District of Columbia to only block Provisional final rule When the arbitrator is required to assist payers and out-of-network providers in a billing dispute, first consider the planned median in-network rate when the parties cannot solve the problem on their own.

The lawsuit alleges that the way in which federal officials structured the arbitration procedure would result in insufficient payment of off-network bills, thereby harming the interests of AHA and AMA members and their patients. These organizations also predict that the system will cause insurance companies to reduce in-network rates, which may force providers to withdraw from the insurance network. American Society of Anesthesiologists sued Blue Cross Blue Shield in North Carolina used unexpected bills last month to lower interest rates.

The AHA and AMA lawsuits argued that the rule also violates the law because the No Accident Law instructs arbitrators to consider the median in-network rate in the region and several other factors when deciding how to deal with disputed bills.

“Congress has established important patient protection measures in the No Accident Act to prevent accidental medical expenses, and doctors are an important part of the legislative solution,” AMA Chairman Dr. Gerald Harmon (Gerald Harmon) said Said at the press conference. “But if the regulatory agency does not comply with the provisions of the law, patients’ access to care may be threatened, because continuous health plan manipulation can create unsustainable conditions for doctors.”

AHA, AMA and other provider groups expressed disappointment with the rules Annotation Submitted to the federal government earlier this week. However, the insurance company stated that the rule is fair and necessary to maintain the objectivity of the dispute resolution process.

Texas Medical Association submitted Own lawsuit In October, they opposed the dispute resolution process of the out-of-network bill, and the hearing is scheduled to be held in February. The rule came into effect on January 1.



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